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Originally Posted by atisketatasket
This might help. Between the blog post and the link to federal poverty guidelines, it looks like it should be household income that determines a sliding scale. So if the niece lives with her mother, household income, but if the niece lives on her own, niece's income (= her household income).
According to the blog post, if therapists offer a sliding scale, they're supposed to offer it to everyone. Which is the not the impression I've gotten.
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She gives some bad advice though, telling people it is "illegal" and "insurance fraud" to charge a different rate for cash paying people. I think that's a myth.
I recommend not reading that blog if you are currently having anger issues.
For those on a sliding scale, she recommends just giving them a certain number of sessions and transferring them to another provider. I don't think it's a good idea to expose someone to therapy than try to brush them off to someone else. The client has a breakdown and so seeks a therapist. The therapist sees the client for 2 months, the client stabilizes, so now its time to transfer the client? That itself could bring on repressed trauma. But it's a win-win for therapists, she says.
Just beware of this practice if you are a sliding scale client.
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It is also reasonable to not offer life-long therapy to an individual client at a rate significantly lower than your Usual and Customary Rate. With that in mind, offering brief, time-limited, solution-focused therapy or crisis stabilization for these same clients can certainly fill a much-needed service gap in most communities. Just make sure that you are ethically meeting your clients’ needs and provide appropriate transitional support to another care provider when needed. What’s not OK is to simply fill your designated low-fee slots for 6 weeks and then to boot those clients out without proper support.
This sounds like a win-win for a lot of therapists. Assuming you can afford to offer reduced-fee time slots, I would certainly support this as a healthy business decision that also serves to ethically and compassionately meet some individual’s needs.
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